| NPI | 1932544798 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q6118) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10045854) | 
| Enumeration Date | 2013-05-07 | 
| Last Update Date | 2016-04-11 |